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General NPI Number Information
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NPI Number | 1538794474
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Entity Type | Organization
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Legal Business Name | GUIDING LIGHT FAMILY SERVICES OF TEXAS, LLC
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Dates
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Enumeration Date | 03/11/2020
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Last Update Date | 03/11/2020
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Provider Practice Location Address
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Address Line | 322 RICHLAND DRIVE
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City | SUGARLAND
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State | TX
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Zip | 77478
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Country | US
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Telephone | 757-735-5413
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Fax |
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Provider Business Mailing Address
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Address Line | 413 B ST
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City | CHESAPEAKE
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State | VA
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Zip | 23324-2515
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Country | US
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Telephone | 757-735-5413
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JADON WILLIAMS
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Credential |
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Telephone | 757-735-5413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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